Damning report into state of continence care

The APPG on Continence Care has released a damning report on continence care. The report highlights a significant decline in the level of provision of continence care services, poor outcomes for patients and soaring costs to the NHS due to poor planning and a lack of early intervention. Costs to the NHS have risen from £77m in 2006/2007 to £121m in 2010/2011.

The APPG report is based on the findings of a survey of 89 respondents from NHS Foundation Trusts, former Primary Care Trusts and other organisations. It follows on from a major survey of continence care in 2007 and reinforces the decline in continence services in terms of both quality and availability.

The survey highlighted that:

• Almost half of services have experienced an increase in patients, but only half of these services report an increase in budget.

• Children and young people seem to be particularly poorly serviced.

• A reduction in specialist staff and senior posts.

• Education of the NHS workforce is a low priority.

• Many services reported supply of continence products was determined by budget rather than clinical need.

Impact of bowel and bladder problems

In the UK, over 20 million people have an on-going bladder or bowel problem, including a million children. Even slight incontinence can have a severe impact on the quality of life of individuals and their families or carers.

In children, continence problems are associated with bullying, low self-esteem and significant family stress – issues that many children may carry with them for the rest of their lives if not tackled early on.

Many continence problems are curable or can be managed effectively when the right support and services are in place.

ERIC's response to the report

Jenny Perez, Director of ERIC, said: "Many children with continence problems are being failed by existing paediatric continence services. For example, there are 13,000 hospital admissions for chronic constipation every year in the under 19s – 90% of which could be avoided through improved early intervention. These failings have huge implications for children and their families; affecting mental and emotional health and wellbeing, attainment at school and parents’ working lives.

"Well-planned, integrated provision is the key to meeting children's and adults' continence needs and improving their wellbeing and quality of life. We want to see NHS England and the Department of Health providing clear commissioning guidance and support to the new Clinical Commissioning Groups, to ensure that people's lives are not blighted by untreated or poorly treated continence problems."

Gill Turton, spokesperson for the Bladder & Bowel Foundation said: "Every month, hundreds of patients are being failed by the NHS, due to poor quality continence care. It is time this overlooked area of healthcare is given a greater priority and patients offered quality care that promotes cure rather than containment, allowing them to lead full and active lives.

"Continence services should not simply be a product dispensing service, and if delivered and managed correctly, can generate cost savings across a broad area of health and social welfare; such as falls prevention, reducing hospital admissions from urinary tract infections, and have a profound impact on maintaining independence, dignity and quality of life."

ERIC and the Bladder & Bowel Foundation are urging the NHS Commissioning Board to fund and carry out an annual national audit of continence services in order to drive up standards in primary, secondary and community settings.

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